RESUMEN
AIM: Physical exercise training attenuates pulmonary inflammation, but its effects on impaired respiratory function caused by hepatopulmonary syndrome (HPS) have not been evaluated. We determined if the combination of moderate intensity aerobic and resistance training during HPS development modifies exercise capacity, respiratory system mechanics, and lung inflammation responses. MAIN METHODS: Wistar rats were randomly divided into sham, HPS, and HPS + combined exercise training groups. Fifteen days after HPS induction, a moderate intensity aerobic plus resistance exercise training protocol was performed five times a week for 5 weeks on alternate days. Exercise capacity, respiratory system mechanics, lung inflammation, pulmonary morphology, and immunohistochemistry were evaluated. KEY FINDINGS: Overall, our findings indicated that combined exercise training efficiently increased the maximal running and resistance capacity of HPS animals. The training regimen reduced the expression of P2X7 in parenchymal leukocytes (P < 0.01), partially restored the expression of interleukin-10 in airway epithelium (P < 0.01), and increased the expression of TFPI in the airway epithelium (P < 0.01) as well as reduced its expression in parenchymal leukocytes (P < 0.01). However, exercise training did not attenuate HPS-induced respiratory mechanical derangements or lung tissue remodeling. SIGNIFICANCE: Combined exercise training can elicit adaptation with regard to both maximal running capacity and maximum strength and modify the expression of P2X7 and TFPI in parenchymal leukocytes and that of IL-10 in airway epithelium.
Asunto(s)
Prueba de Esfuerzo/métodos , Tolerancia al Ejercicio/fisiología , Síndrome Hepatopulmonar/terapia , Condicionamiento Físico Animal/métodos , Condicionamiento Físico Animal/fisiología , Neumonía/terapia , Animales , Síndrome Hepatopulmonar/patología , Síndrome Hepatopulmonar/fisiopatología , Masculino , Neumonía/patología , Neumonía/fisiopatología , Ratas , Ratas Wistar , Mecánica Respiratoria/fisiologíaRESUMEN
Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR) program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8). At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal inspiratory pressure, improvements on two components from the health-related quality-of-life questionnaire, and a decrease in plasma IL-8 levels after the intervention. The HBPR is an important and viable alternative to pulmonary rehabilitation for the treatment of patients with COPD; it improves exercise tolerance, inspiratory muscle strength, quality of life, and systemic inflammation in COPD patients.
Asunto(s)
Terapia por Ejercicio , Tolerancia al Ejercicio , Servicios de Atención a Domicilio Provisto por Hospital , Inflamación/rehabilitación , Pulmón/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Terapia Respiratoria/métodos , Anciano , Biomarcadores/sangre , Brasil , Citocinas/sangre , Prueba de Esfuerzo , Femenino , Humanos , Inflamación/sangre , Inflamación/diagnóstico , Inflamación/fisiopatología , Mediadores de Inflamación/sangre , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Enfermedad Pulmonar Obstructiva Crónica/sangre , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Calidad de Vida , Recuperación de la Función , Músculos Respiratorios/fisiopatología , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del TratamientoRESUMEN
INTRODUCTION: Pulmonary rehabilitation (PR) is a multidisciplinary program of care for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving the functional capacity and quality of life, as well as maintaining the clinical stability of COPD sufferers. However, not all patients are available for such a program despite discomfort with their condition. The aim of this study was to evaluate the effects of a home-based PR (HBPR) program on functional ability, quality of life, and respiratory muscle strength and endurance. PATIENTS AND METHODS: Patients with COPD according to the Global Initiative of Chronic Obstructive Lung Disease were randomized (double-blind) into two groups. One group performed a protocol at home with aerobic and muscle strength exercises and was called the intervention group; the other group received only instructions to perform breathing and stretching exercises, characterizing it as the control group (CG). We assessed the following variables at baseline and 2 months: exercise tolerance (incremental shuttle walk test and upper limb test), respiratory muscle (strength and endurance test), and health-related quality of life (Airways Questionnaire 20). RESULTS: There were no significant changes after the intervention in either of the two groups in exercise tolerance and quality of life. However, the intervention group had improved respiratory endurance compared with the CG, while the CG presented a decrease in the load sustained by the respiratory muscles after the HBPR. CONCLUSION: A program of HBPR with biweekly supervision (although not enough to provide significant improvements in physical capacity or quality of life) played an important role in maintaining the stability of the clinical features of patients with COPD; the patients had no worsening of symptoms during the intervention period according to the daily log.
Asunto(s)
Terapia por Ejercicio , Pulmón/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Músculos Respiratorios/fisiopatología , Anciano , Brasil , Ejercicios Respiratorios , Método Doble Ciego , Tolerancia al Ejercicio , Femenino , Servicios de Atención a Domicilio Provisto por Hospital , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular , Ejercicios de Estiramiento Muscular , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/psicología , Calidad de Vida , Recuperación de la Función , Factores de Tiempo , Resultado del TratamientoRESUMEN
JUSTIFICATIVA E OBJETIVOS: A corrente polarizada pode ser utilizada em diferentes tipos de lesões, contudo a literatura é escassa no campo fisioterapêutico. O objetivo deste estudo foi apresentar por meio de revisão da literatura os efeitos da corrente polarizada e explorar suas diferentes formas de aplicação pela fisioterapia. CONTEÚDO: Utilizaram-se os bancos de dados LILACS, Medlinee Scielo com as seguintes palavras-chave: corrente polarizada;corrente galvânica; corrente farádica; corrente exponencial; correntes Diadinâmicas de Bernard; corrente de alta voltagem;microcorrente; iontoforese. Foram revisadas 13 referências bibliográficas, do período de 1983 a 2009, além do uso de estudos não indexados a essas bases de dados para a contextualização do assunto. Encontrou-se que esse tipo de corrente proporciona benefícios à pacientes com complicações traumato-ortopédicas, neurológicas, desportivas ou até mesmo pós-mastectomia, em virtude de seu efeito analgésico, anti-inflamatório, vascular, eletroestimulador, cicatricial e ósseo. CONCLUSÃO: A analgesia, os efeitos vasculares e cicatriciais são os mais citados pelos estudos encontrados, destacando-se o uso da corrente diadinâmica de Bernard e da corrente de alta voltagem. No entanto, outros estudos deverão ser realizados para que maiores conclusões sejam obtidas.
BACKGROUND AND OBJETIVES: The polarized current can be used in different types of injuries, but the literature is scarce in the physical therapy . The aim of this study was to present through literature the effects of polarized current and explore different ways of applying for physiotherapy. CONTENTS: We used the databases LILACS, Medline and Scielo with the following keywords: polarized current, galvanic current,faradic current; current exponential; diadynamic Bernard; high voltage current, microcurrent, iontophoresis. 13 references were reviewed from the period 1983 to 2009, and the use of other not indexed studies for the contextualization of the subject. Found that this type of current provides benefits to patients with trauma-orthopedic complications, neurological, sports or evenpost mastectomy because of their analgesic effect, anti-inflammatory,vascular, nerve stimulators and bone healing. CONCLUSION: Analgesia, the vascular and tissue healing effects are the most cited studies found by polarized current, especially the use of diadynamic Bernard current and high voltage current. However, other studies should be conducted to further conclusions can be made.